AAN 69th ANNUAL MEETING ABSTRACT
Media Contacts:
Renee Tessman, [email protected], (612) 928-6137
Michelle Uher, [email protected], (612) 928-6120
EMBARGOED FOR RELEASE UNTIL 4 P.M. ET, WEDNESDAY, MARCH 1, 2017
Abstract Title: Self-reported Fatigue and Lower Limb Problems Predictive of Conversion to
Secondary Progressive Multiple Sclerosis in an Aging Sample of Patients
Press Release Title: How Can We Predict Whose MS Will Worsen?
Objective: To investigate patient reported outcomes predictive of conversion to SPMS in an aging
sample of MS patients.
Authors: Caila Vaughn, Katelyn Kavak, Aisha Bushra, Ekaterina Noyes, Keith Edwards, Andrew
Goodman, Patricia Coyle, Lauren Krupp, Burk Jubelt, Malcolm Gottesman, Ralph Benedict,
Bianca Weinstock-Guttman
Background: The secondary progressive (SP) phase of multiple sclerosis (MS) is characterized by
a progressive accumulation of neurological disability, preceded by a relapsing remitting (RR)
disease course. Older age at disease onset, high frequency of relapses and male sex have frequently
been found to be predictive of a higher risk of disease conversion.
Design/Methods: Subjects are part of the New York State Multiple Sclerosis Consortium
(NYSMSC). Patients with an RRMS disease type at study enrollment, age 50 or over, with a
disease duration of at least 15 years were selected for this study (n=155). Chi-squared tests and
logistic regression modelling were used to investigate the predictive value of patient reported
outcomes at study enrollment and conversion to SPMS at year five.
Results: Five years after study enrollment (median disease duration=22 years), 47 (30.3%) RRMS
subjects progressed to SPMS. Those who converted were older at study enrollment (54.8 vs 52.1,
p=.01), and had a higher Kurtzke Expanded Disability Status Scale (EDSS) at both baseline (3.5 vs
2.6, p<.001), and at year 5 (5.6 vs 3.0, p<.001). Patients who progressed at year five were more
likely to report lower limb problems at baseline (53.2% vs 21.5%, OR: 3.0, p<.001), and were
more likely to report some degree of fatigue (91.5% vs 68.2%, OR: 4.2, p=.004), compared to
those who did not progress, even after adjusting for age, disease duration and EDSS. Fatigue and
lower limb problems were strongly correlated (p-value=0.001).
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Conclusions: Fatigue and lower limb problems at baseline were predictive of a higher chance of
conversion after five years of follow-up. Targeting patients with these symptoms may result in
more successfully predicting patients at higher risk of disease conversion and subsequently
tailoring therapeutic strategies.
Study Supported by: The study was supported by the National Multiple Sclerosis Society grant
HC-1411-02004